California Colonial Life
10-100 EE Block Offer
Client Name
Proposal Date
Producer Name
Account Manager Name
Employee Count
Benefit Effective Date
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Product Selection
Select voluntary benefits
AC
Accident Insurance
Plan
Basic
Premier
Both
CI
Critical Illness
HI
Hospital Indemnity
Plan Type
Plan 1 (HSA)
Plan 2 (Standard)
Both
Admission Level 1
$500
$1,000
$2,000
Admission Level 2 (Optional)
None
$500
$1,000
$2,000
GTL
Group Term Life
Components
Basic Only
Voluntary Only
Both
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Producer Email
Account Manager Email
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